The Role of Relaparoscopy in the Management of Early Bariatric Surgery Complications and 30-Day Outcome: a Tertiary Centre Experience.
30-day outcome
Bariatric surgery complication
Gastric bypass
Sleeve gastrectomy
Journal
Obesity surgery
ISSN: 1708-0428
Titre abrégé: Obes Surg
Pays: United States
ID NLM: 9106714
Informations de publication
Date de publication:
08 2021
08 2021
Historique:
received:
11
08
2020
accepted:
29
03
2021
revised:
28
03
2021
pubmed:
22
4
2021
medline:
21
7
2021
entrez:
21
4
2021
Statut:
ppublish
Résumé
The laparoscopic approach for dealing with bariatric complications has become the gold standard of modern practice. The aim of this study is to assess the role of relaparoscopy as a diagnostic and therapeutic approach towards managing complications and improving 30-day outcome. A retrospective review of a prospectively maintained database was conducted in a tertiary bariatric unit. Data were collected on all bariatric surgical procedures performed between March 2013 and March 2019. Any patient who was returned to theatre for a suspected serious complication was identified and their outcome studied. Over the 5-year study period, the total number of operations performed was 1660 (981 laparoscopic gastric bypass (LRYGB), 612 laparoscopic sleeve gastrectomy (LSG) and 67 revisional bariatric operations). Early postoperative complications (in hospital or within 30 days of surgery) that lead to reoperation were recorded in 33 patients (1.9%). These complications occurred after LRYGB in 26 patients (2.65%) and LSG in 7 patients (1.14%), respectively. Anastomotic leaks occurred in 1.1% of LRYGB, whilst 0.6% of patients have jejuno-jejunostomy obstruction. Obstruction at the gastro-jejunostomy anastomosis occurred in one patient. Following LSG, one mortality was recorded following bleeding from the staple line (0.06%) and five patients (0.3%) had leaks from the staple line. Thirty-one reoperations were performed laparoscopically, and two were converted to the open approach, whilst 2 operations were planned as open from the outset. Relaparoscopy is an effective and safe approach to the management of clinically or radiologically suspected early complications after bariatric surgery. Graphical abstract.
Identifiants
pubmed: 33881739
doi: 10.1007/s11695-021-05401-1
pii: 10.1007/s11695-021-05401-1
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
3462-3467Commentaires et corrections
Type : CommentIn
Informations de copyright
© 2021. Crown.
Références
Dexter S, Miller GV, Davides D, et al. Relaparoscopy for the detection and treatment of complications of laparoscopic cholecystectomy. Am J Surg. 2000;179(4):316–9.
doi: 10.1016/S0002-9610(00)00345-7
McCormick JT, Simmang CL. Reoperation following minimally invasive surgery: are the “rules” different? Clin Colon Rectal Surg. 2006;19(4):217–22.
doi: 10.1055/s-2006-956443
El Chaar M, Lundberg P, Stoltzfus J. Thirty-day outcomes of sleeve gastrectomy versus Roux-en-Y gastric bypass: first report based on Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program database. Surg Obes Relat Dis. 2019;14(5):545–51.
doi: 10.1016/j.soard.2018.01.011
Smith MD, Patterson E, Wahed AS, et al. 30-day mortality after bariatric surgery: independently adjudicated causes of death in the longitudinal assessment of bariatric surgery'. Obes Surg. 2011;21(11):1687–92.
doi: 10.1007/s11695-011-0497-8
Jacobsen HJ, Nergard BJ, Leifsson BG, et al. Management of suspected anastomotic leak after bariatric laparoscopic Roux-en-y gastric bypass. Br J Surg. 2014;101(4):417–23.
doi: 10.1002/bjs.9388
Gorecki P, Wise L, Brolin RE, et al. Complications of combined gastric restrictive and malabsorptive procedures. Curr Surg. 2003;60(2):138–44.
doi: 10.1016/S0149-7944(02)00794-8
Albert T, Spaw JD. Husted. Bleeding after laparoscopic gastric bypass: case report and literature review. Surg Obes Relat Dis. 2005;1(2):99–103.
doi: 10.1016/j.soard.2005.02.013
Gagner M, Deitel FM, Kalberer TL, et al. The second international consensus summit for sleeve gastrectomy. Surg Obes Relat Dis. 2009;5(4):476–85.
doi: 10.1016/j.soard.2009.06.001
Gonzalez G, Nelson LG, Gallagher SF, et al. Anastomotic leaks after laparoscopic gastric bypass. Obes Surg. 2004;14(10):1299–307.
doi: 10.1381/0960892042583978
Sauerland S, Agresta F, Bergamaschi R, et al. Laparoscopy for abdominal emergencies: evidence-based guidelines of the European Association for Endoscopic Surgery. Surg Endosc. 2005;20(1):14–29.
doi: 10.1007/s00464-005-0564-0
Fernandez Jr AZ, DeMaria EJ, Tichansky DS, et al. Experience with over 3,000 open and laparoscopic bariatric procedures: multivariate analysis of factors related to leak and resultant mortality. Surg Endosc. 2004;18(2):193–7.
doi: 10.1007/s00464-003-8926-y
Sundbom M, Näslund E, Vidarsson B, et al. Low overall mortality during 10 years of bariatric surgery: nationwide study on 63,469 procedures from the Scandinavian Obesity Registry. Surg Obes Relat Dis. 2020;16(1):65–70.
doi: 10.1016/j.soard.2019.10.012
Iannelli A, Buratti MS, Novellas S, et al. Internal hernia as a complication of laparoscopic Roux-en-Y gastric bypass. Obes Surg. 2005;17(10):1283–6.
doi: 10.1007/s11695-007-9229-5
Stenberg E, Szabo E, Agren G, et al. Closure of mesenteric defects in laparoscopic gastric bypass: a multicentre, randomised, parallel, open-label trial. Lancet. 2016;387(10026):1397–404.
doi: 10.1016/S0140-6736(15)01126-5
Carucci LR, Turner MA. 'Radiologic evaluation following Roux-en-Y gastric bypass surgery for morbid obesity. Eur J Radiol. 2005;53(3):353–65.
doi: 10.1016/j.ejrad.2004.12.010